MANAGEMENT OF MULTILEVEL LUMBAR DISC HERNIATION
Multilevel Lumbar Disc Herniation
Objective: To identify and document more then one level symptomatic lumbar disc herniation and to find its frequency presentation and outcome.
Design: Descriptive study
Place and Duration of Study: Combined Military Hospital Rawalpindi from 2001 to 2002.
Patients and Methods: A total number of 260 male patients were selected from out patient department over a period of 1 year. After clinical evaluation, confirmation was done by nonenhanced Electro-resonance imaging (MRI) of the lumbar spine. All the patients with multilevel disc herniation on MRI underwent never conductions (NCS) electromyography (EMG) studies.
Results: All the patients were males. Maximum number of patients was between 32 - 40 years of age; mean age was 35 with a standard deviation of 2. 48 belonged to military setup and 82 were civilians. Out of all, 14 had multilevel lumbar disc herniations, the frequency being 5.8 in our study. All the patients with multilevel disc herniations underwent surgery. Only 4 patients had multilevel discectomy where 10 had discectomy at single level. Mortality was nil and there were no postoperative neurological deficits. All the patients were back to work at 6 weeks. Data was analyzed using the descriptive SPSS package.
Conclusions: The identification of symptomatic multilevel disc herniation is extremely important in order to manage the patients with multilevel disc herniation as single level discectomy in such patients will not ameliorate the symptoms and may require another difficult surgery.